Primary and secondary immune thrombocytopenia (ITP): Time for a rethink

IF 6.9 2区 医学 Q1 HEMATOLOGY
Tomás José González-López , Drew Provan , Abelardo Bárez , Angel Bernardo-Gutiérrez , Silvia Bernat , Daniel Martínez-Carballeira , Isidro Jarque-Ramos , Inmaculada Soto , Reyes Jiménez-Bárcenas , Fernando Fernández-Fuertes
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引用次数: 2

Abstract

There are not many publications that provide a holistic view of the management of primary and secondary ITP as a whole, reflecting the similarities and differences between the two. Given the lack of major clinical trials, we believe that comprehensive reviews are much needed to guide the diagnosis and treatment of ITP today. Therefore, our review addresses the contemporary diagnosis and treatment of ITP in adult patients. With respect to primary ITP we especially focus on establishing the management of ITP based on the different and successive lines of treatment. Life-threatening situations, “bridge therapy” to surgery or invasive procedures and refractory ITP are also comprehensively reviewed here. Secondary ITP is studied according to its pathogenesis by establishing three major differential groups: Immune Thrombocytopenia due to Central Defects, Immune Thrombocytopenia due to Blocked Differentiation and Immune Thrombocytopenia due to Defective Peripheral Immune Response. Here we provide an up-to-date snapshot of the current diagnosis and treatment of ITP, including a special interest in addressing rare causes of this disease in our daily clinical practice. The target population of this review is adult patients only and the target audience is medical professionals.

原发性和继发性免疫性血小板减少症(ITP):是时候重新思考了
没有多少出版物能从整体上对原发性和继发性ITP的管理提供全面的看法,反映出两者之间的异同。鉴于缺乏主要的临床试验,我们认为现在非常需要全面的综述来指导ITP的诊断和治疗。因此,我们的综述涉及成人ITP的当代诊断和治疗。关于原发性ITP,我们特别关注建立基于不同和连续治疗线的ITP管理。本文还对危及生命的情况、手术或侵入性手术的“桥接疗法”和难治性ITP进行了全面综述。根据继发性ITP的发病机制,建立了三个主要的鉴别组:中心缺陷引起的免疫性血小板减少症、分化障碍引起的免疫型血小板减少症和外周免疫反应缺陷引起的免疫力低下症。在这里,我们提供了ITP当前诊断和治疗的最新快照,包括在我们的日常临床实践中对解决这种疾病的罕见原因的特殊兴趣。本综述的目标人群仅为成年患者,目标受众为医疗专业人员。
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来源期刊
Blood Reviews
Blood Reviews 医学-血液学
CiteScore
13.80
自引率
1.40%
发文量
78
期刊介绍: Blood Reviews, a highly regarded international journal, serves as a vital information hub, offering comprehensive evaluations of clinical practices and research insights from esteemed experts. Specially commissioned, peer-reviewed articles authored by leading researchers and practitioners ensure extensive global coverage across all sub-specialties of hematology.
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